The Trump Officials Making Abortion an Issue at the U.S.’s Refugee Office

Officials installed by the Trump Administration are responsible for the Office of Refugee Resettlement’s new lurch into abortion politics, including the recent case of “Jane Doe.”

Photograph by Michael S. Williamson / The Washington Post via Getty

The Department of Health and Human Services has a trillion-dollar
operating budget, a staff of close to eighty thousand, and more than a
hundred programs under its watch, including Medicare, Medicaid, the Food
and Drug Administration, and the Centers for Disease Control and
Prevention. It also oversees the Office of Refugee Resettlement, a
relatively small program tasked with caring for recently arrived
refugees. During the past month, O.R.R., in defiance of state and
federal court orders, tried to keep a seventeen-year-old girl in its
custody from having an abortion. Identified only as “Jane Doe,” she was
living in an O.R.R.-funded shelter in Texas, where state law prohibits
abortions after twenty weeks. At issue wasn’t the use of federal money
(a nonprofit raised the funds necessary for the abortion) or logistics
(the girl’s legal guardian had offered to transport her to and from a
medical facility). The matter was political. Justice Department lawyers
argued, in court, that O.R.R. has “strong and constitutionally
legitimate interests in promoting childbirth, in refusing to facilitate
abortion, and in not providing incentives for pregnant minors to
illegally cross the border to obtain elective abortions while in federal
custody.” Earlier this week, a federal appeals court ordered O.R.R. to
stand down. Blocking the girl’s abortion, the judges wrote, was a “grave
constitutional wrong.” On Wednesday morning, Jane Doe, who was nearly
sixteen weeks pregnant, had the abortion before the government could
further interfere.

The fact that O.R.R. was at the center of the controversy—and the object
of such a dramatic judicial rebuke—shocked many who worked there in the
past. “I have seen this office in Republican and Democratic
Administrations, and the position it’s taken here doesn’t track with
either,” Robert Carey, who served as the head of O.R.R. during the last
two years of the Obama Administration, told me recently. “The
decision-making looks uniquely ideologically driven.” The program is
staffed by public-health professionals, N.G.O. veterans, and
immigrants’-rights advocates. “It’s always been a mission-driven
office,” Carey said. O.R.R.’s main responsibilities are finding homes
and providing health care for foreigners who have refugee status in the
U.S. In recent years, it also has housed and supported a population of
more than a hundred and seventy-five thousand immigrants known as
unaccompanied minors—children, mostly from Central America, who have
arrived in the U.S. without their parents and whose legal cases are
pending. “Jane Doe” is one of them. O.R.R. places these children in
shelters administered by different aid organizations, where they’re
supposed to have access to a full range of medical procedures, including
abortions. In the past, some shelters operated by religious groups
refused to facilitate abortions, but, in 2011, O.R.R. modified its
policy to support the shelters that promised to offer complete medical
care. “Absolutely everything in the lives of these kids is controlled by
the shelters where they’re placed,” Maria Cancian, a professor at the University of
Wisconsin who worked at H.H.S. in the Obama Administration,
told me. “They generally don’t leave. Food, medical care, talking to
their parents are all controlled by the shelter. If we place girls in
shelters where providers have a strong ideology opposed to providing
services, we’re putting them in an impossible position.” It has been
estimated that sixty per cent of girls who make the trip alone to the
United States from Central America are raped or sexually assaulted on
their journey.

O.R.R. and H.H.S. leaders installed by the Trump Administration are
responsible for the office’s new lurch into abortion politics. In late
March, E. Scott Lloyd, who once served as a lawyer for the Catholic
advocacy organization Knights of Columbus and who has a long and
well-documented history of outspoken anti-abortion views, became the
director of O.R.R. He came to the program with limited experience in
refugee-related issues, and many attributed his appointment to his
conservative credentials. A member of the Republican National Lawyers
Association, he served as an attorney for H.H.S. during the Bush
Administration, where he co-wrote a controversial policy called the
medical “conscience
rule,” to
defend health-care providers that opposed abortion on moral or religious
grounds. “It does seem that maybe ideology or perceived loyalty to a
particular set of values is being valued more highly than experience
running an agency, or organizational skills, or experience with
refugees,” one immigration lawyer told the Daily
Beast after Lloyd was officially tapped. Lloyd flew to Texas to meet with a
pregnant girl living in an O.R.R. shelter, to try to persuade her not to
have an abortion. On March 30th, two days after he became the head of
O.R.R., Lloyd sent an e-mail to his staff with an explicit directive.
“Grantees”—meaning shelters that receive O.R.R. grants—“should not be
supporting abortion services pre or post-release,” he wrote. “Only
pregnancy services and life-affirming options counseling.”

A trove of internal O.R.R. documents was made public during the
litigation over Jane Doe’s abortion, and they show that the program was
generating new policies concerning abortions even before Lloyd took
over. One memo, dated March 4th, declared that, in situations where an
unaccompanied minor “may be involved in an abortion,” shelters were
“prohibited from taking any action that facilitates an abortion without
direction and approval from the Director of ORR.” The same memo
described an incident that took place the day before, when a girl at a
shelter in San Antonio, who had already received a judge’s permission
for an abortion, took an initial dose of mifepristone, a drug used to
terminate early-stage pregnancies. Before she could take the next dose,
O.R.R. intervened. Officials drove her to a nearby emergency room to
assess her and her fetus’s “health status.” After legal pressure, O.R.R.
relented, and she was allowed to take a dose of a second drug, called
misoprostol, to complete the procedure.

Another official behind O.R.R.’s renewed interest in abortion issues is
Margaret Wynne, an H.H.S. veteran who worked under Presidents George W. Bush and
Barack Obama, and who now serves as counsellor for human-services policy at
H.H.S. One H.H.S. veteran described Wynne’s job as “the main
trouble-shooter for all the human-services activities at H.H.S.” and the
point person for any policy issue before it reaches the head of the
entire department.

Several of Wynne’s former colleagues described her to me as ardently
pro-life. Like Lloyd, she once worked at the Knights of Columbus, and
before joining H.H.S. she served as the
director of the House of Representatives Pro-Life Caucus. Under Obama, Wynne ran
O.R.R.’s anti-human-trafficking program, overseeing a team of social
workers who assessed the eligibility of foreign-born trafficking victims
to get temporary public-health benefits. “She did not trust the stories
of these individuals anytime a lawyer was involved,” one former
colleague told me. “She assumed the lawyers were coaching victims to get
benefits. And any time a kid’s story changed, she acted like they were
lying.” (Wynne, through an H.H.S. spokesperson, disputed this
characterization.)

Wynne left H.H.S., in 2016, after years of clashing with other officials
in the Obama Administration, but she returned to serve on the transition
team at H.H.S. after last November’s election. Being one of the only
political appointees at the department with extensive prior experience
involving O.R.R. contributed to her clout. Until Lloyd took over,
staffers at O.R.R. reported to her. “O.R.R.’s policies reflect her
choices,” one former official, who still has close ties to the office,
told me. (“O.R.R.’s policies reflect those of the Administration, and
Maggie is in H.H.S to support them,” an H.H.S. spokesperson said.)

The A.C.L.U., which has represented Jane Doe, maintains that there are
hundreds of other girls in O.R.R.’s care who are pregnant. It’s unclear
how Wednesday’s ruling will affect them if they, like Jane Doe, seek to
have abortions. “I don’t think the government is going to modify its
policies until a court forces them,” Brigitte Amiri, Jane Doe’s lawyer,
told me after the ruling. O.R.R., under Lloyd’s leadership, is currently
directing unaccompanied minors who have requested abortions to so-called
crisis pregnancy centers, where they are encouraged to carry their
pregnancies to term. Carey, the former O.R.R. head, is concerned such
practices will continue. “Policy is being issued by fiat over e-mails
and through memos,” he told me. “Will girls be provided counselling
about all their options? Will they have access to legal representation?
These are all open questions.”